Anales de pediatría : publicación oficial de la Asociación Española de Pediatría (A.E.P.)
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Brain death is the irreversible cessation of intracranial neurologic function and is considered as the person's death. The objective of this study was to describe the characteristics of pediatric donors in the Hospital Central de Asturias from October 1995 to October 2002. ⋯ In our PICU more than one-third of the dead children suffered brain death, and most became donors. The most frequent cause of brain death was multiple trauma. Coordination with the transplant team and the training of medical staff are important to achieve a high percentage of donations.
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The Cochrane Neonatal Collaborative Review Group (CNRG) is one of the most important collaborative review groups registered in the Cochrane Collaboration (CC) and provides a growing and readily accessible source of information to help neonatologists base their care on detailed, critical, and up-to-date reviews of the best available evidence. The objective of this article was to perform a bibliometric analysis (quantitative and qualitative) of the systematic reviews (SR) published in the Neonatal Cochrane Collaboration (NCC) and to identify the subject areas studied by the CNRG in which decision-making in clinical practice is based on the best available evidence. ⋯ Although CC reviews are based on specific guidelines, errors and biases occur, suggesting the need to "review the reviews". The bibliometric analysis of the NCC shows that the quality of published SR varies, and the main conclusion is that almost half of the reviewers' conclusions are insufficient to infer probable effects in clinical practice. There is a lack of scientific evidence on many therapies in neonatology and, at the moment, the SR published in the NCC enable evidence-based decision making mainly in the subject area of respiratory diseases and gastroenterology-nutrition. Challenges for the future include the need for bigger and better clinical trials in this field (with long-term outcomes among surviving children), the preparation of systematic reviews on topics not yet covered, and keeping an increasing number of reviews up-to-date. Every decision in neonatology should be based on a systematic appraisal of the best evidence available in the context of the prevailing values and resources at our disposal.
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Pediatric ankle injuries are a common complaint in the emergency setting. The objective of this study was to prospectively validate the Ottawa ankle rules (OAR) in children in Mexico. This could reduce costs and waiting times in the emergency room. ⋯ The sensitivity and applicability of the OAR in children in Latin-America are confirmed, although reduction in the use of radiography is lower than in other countries.
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Atopic dermatitis is closely related to other atopic diseases, especially asthma and allergic rhinitis. Although there is a certain agreement that suffering from atopic eczema predisposes to asthma and allergic rhinitis, the risk of developing these diseases should be quantified in populations following a standardized method, which is the objective of this study. ⋯ Quantification of risk showed that schoolchildren with atopic eczema had a 3-fold risk of allergic rhinitis (OR: 3.33; 95 % CI: 2.45-4.54), a 4-fold risk of asthma (OR: 3.85; 95 % CI: 2.74-5.42) and a 5-fold risk of allergic asthma (OR: 4.91; 95 % CI: 3.17-7.59) compared with schoolchildren without atopic eczema. The severity of eczema was also directly related to that of asthma and rhinitis.